Waiting often ordeal for elderly

Sunday

Jun 16, 2013 at 6:00 AMJun 16, 2013 at 7:45 AM

Anyone who cares for an elderly parent knows it’s often difficult to get them to the doctor.

Some elders have physical challenges and need time to prepare. Some just don’t want to go. Before she moved to a nursing home, my own mom would drive us to distraction with last-minute touches to her make-up.

Iva Evans uses a cane. The 94-year-old Worcester woman lives with her daughter, Floretta DeBoise, who is in her 70s. Ms. Evans is in fine health, but when she has a doctor’s appointment it takes her awhile to get ready.

That was the case May 31, when Ms. DeBoise drove her to an 11:30 a.m. appointment on Lincoln Street. They got to the office at 11:20; at 11:50 they were called into an exam room. Ms. Evans sat on a metal exam table and a nurse took her blood pressure. Then an office worker came in and asked a couple of questions.

“At one point, the doctor came to the door and said she’d be right in,” Ms. DeBoise recalled. “By then, almost an hour had gone by. My mother was getting tired. She asked, ‘Is it OK if I lay back on the table?’ ”

Ms. DeBoise said she asked three different staffers when the doctor would be in. Each time she got the same answer: soon. At one point she walked into the hall and saw the doctor talking to two staff members. She said there seemed to be no emergency and no chaotic situation that would explain a delay.

Ms. DeBoise returned to the exam room. By now it was 1:20 p.m. They had been waiting for almost two hours.

“I said to my mom, ‘Let’s get out of here,’ ” Ms. DeBoise recalled. As they headed to the elevator, a staffer followed with a form that the doctor requested they sign.

“It said something about how I left the office voluntarily, so if anything happened to my mother, it would be my fault,” Ms. DeBoise said. “I said, ‘I’m not signing anything,’ and we left.”

The doctor in this case was Helen Carter. Last fall, Dr. Carter made national news for her decision to reject new patients who weigh more than 200 pounds, saying several staff members had been injured assisting overweight patients.

Of course, it would be unfair to assume that Dr. Carter discriminates against the elderly just because she discriminates against fat people. And doctors can run behind schedule for unforeseen reasons, such as emergencies or patients who show up late.

I called Dr. Carter’s office last week. The next morning, about 6:30 a.m., she returned my call and said she got my message. I asked if we could talk later that day and she said she had a full schedule, so I asked if we could talk right then and she said she needed permission from UMass Memorial Medical Center, where she has staff privileges. If she didn’t call me back, she said, it was because of UMass.

She didn’t call me back, and I wondered, frankly, why she called in the first place. So I reached out to UMass, and a spokesman issued a statement that noted Dr. Carter is a “private, independent physician not employed by our Medical Group.” It also noted that “unforeseeable situations can arise” in health care that call for “open communication” with the patient.

“Practices such as informing a patient if there is to be a longer wait than expected, or giving patients the option to reschedule are just a few ways that our physicians can manage such unexpected situations.” A second spokesman said Dr. Carter doesn’t need permission from UMass to speak with the press.

Maybe Dr. Carter is communication-challenged in general. Ms. Evans said she wouldn’t have been so frustrated if someone had simply told her the doctor was running late.

“I know I’m old,” she said. “But she should pay me some attention. I didn’t want to be rude, so I just sat there.”

Doctors get busy, but a 94-year-old patient should never have to just sit there.